Global progress towards tackling obesity has been "unacceptably slow", with only one in four countries implementing a policy on healthy eating up to 2010, according to a new six-part series on obesity published in The Lancet.
In less than a generation the rates of child obesity have risen dramatically worldwide, the series says, noting that although child obesity rates have started to level off in some cities and countries, no country to date has experienced declining rates of obesity across its population.
"Our understanding of obesity must be completely reframed if we are to halt and reverse the global obesity epidemic,” said Dr Christina Roberto, from the Harvard T.H. Chan School of Public Health, USA. “On one hand, we need to acknowledge that individuals bear some responsibility for their health, and on the other hand recognise that today's food environments exploit people's biological (eg, innate preference for sweetened foods), psychological (eg, marketing techniques), and social and economic (eg, convenience and cost) vulnerabilities, making it easier for them to eat unhealthy foods.”
"It's time to realise that this vicious cycle of supply and demand for unhealthy foods can be broken with 'smart food policies' by governments alongside joint efforts from industry and civil society to create healthier food systems."
According to Series lead Professor Boyd Swinburn from the University of Auckland, New Zealand, the key to meeting the World Health Organisation’s (WHO) target to achieve no further increase in obesity rates by 2025, will be strengthening accountability systems to support government leadership, limiting the role of the food industry in the formation of public health policy, and encouraging consumers to create a demand for healthy food.
“Obesity is a complex issue in a world where globalisation is accompanied by ever increasing profit expectations, rapid social development exists alongside extreme poverty, new social media give uncontrolled opportunities for advertising, and increasing inequality poses real threats to our future,” said Lancet editor Professor Richard Horton and colleagues, writing in a commentary that accompanies the series.
“Halting and then reversing the obesity pandemic by changing our societal approach to food, beverages, and physical activity is not an optional choice or a target that can be missed. It is one of the most important challenges that must be tackled collectively by our civilisations.”
The Lancet series covers a range of topics and opinions, from obesity prevention policies, to gaining public support and improving health care systems and training.
Targeting children?
In the fourth article in the series experts claim that the food industry has a ‘special interest’ in targeting children, suggesting that repeated exposure to highly processed foods and sweetened drinks during infancy builds taste preferences, brand loyalty, and high profits.
This year the global market for processed infant foods is expected to be worth $19 billion (€16.7bn), up from $13.7bn (€12bn) in 2007, says the report, led by Professor Tim Lobstein, from the World Obesity Federation.
"Fat children are an investment in future sales," commented Lobstein.
Despite the strong expected growth in infant foods and foods aimed at children, few countries have taken regulatory steps to protect children from the negative health effects of obesity or implemented widely-recommended healthy food policies – with most countries relying solely on voluntary moves by the food industry, with no evidence of their effectiveness, warned the authors.
“Whereas much public health effort has been expended to restrict the adverse marketing of breastmilk substitutes, similar effort now needs to be expanded and strengthened to protect older children from increasingly sophisticated marketing of sedentary activities and energy-dense, nutrient-poor foods and beverages,” they wrote.
Changing the environment
The series authors call for food policies that change the nature of the food and consumer environment through ‘smart food policies’ that include modifying the availability, price, and nutrition standards of food products, and the marketing practices that influence food choices and preferences.
“Smart food policies emerge as policies that strategically target food preference formation, expression, and reassessment in the broader context of environments and systems. Smart policies therefore extend beyond making healthy choices the easy choices to making healthy choices the preferred choices,” wrote the authors.
“Well designed food policies have substantial potential to meaningfully and sustainably improve diets locally, nationally, and worldwide, including among disadvantaged groups, and therefore have an essential part to play in curbing the global obesity epidemic.”
Examples of smart policies could include tighter supervision and international regulation of the food supply, an international code of food marketing to protect children's health, regulating food nutritional quality in schools along with programmes to encourage healthy food preferences, taxes on unhealthy products such as sweetened drinks and subsidies on healthier foods for low-income families such as vouchers for fruit and vegetable boxes, and mandatory food labelling as an incentive for industry to produce more nutritional products, said the team.
Source: The Lancet